Lateral Epidural Stimulation for Kidney Function

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Solution Overview

Problem

Current methods for managing heart failure, particularly acute decompensated heart failure, are inadequate as they lead to diuresis resistance and kidney damage due to chronic use of loop diuretics, and they require invasive procedures with potential side effects, such as pain and foraminal stenosis, during dorsal root ganglion stimulation.

Innovation Solution

The system employs electrical stimulation of preganglionic dorsal root fibers using electrodes to activate renal afferent nerves, inhibiting renal efferent nerves, thereby promoting diuresis and reducing blood volume, with a computing apparatus controlling the stimulation to minimize side effects and improve targeting precision.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Productivity

If loop diuretics are used chronically to manage heart failure, then diuresis is initially achieved, but diuresis resistance develops and kidney damage occurs

Engineering Contradiction:

Improvediuresis effectivenessVSAvoidkidney function

Core Design Contradiction:

ProductivityVSReliability

Solution Approach 1:

The patent replaces the chemical mechanism of loop diuretics with an electrical stimulation mechanism. Electrical signals are applied to renal afferent nerves to activate the reno-renal reflex, which naturally inhibits renal efferent nerves and promotes diuresis. This substitution eliminates the progressive kidney damage associated with chronic diuretic use while maintaining effective diuresis promotion through a non-chemical pathway.

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

2Reliability

If dorsal root ganglion stimulation is performed to promote diuresis, then kidney function is improved, but invasive procedures cause pain and foraminal stenosis

Engineering Contradiction:

Improvekidney functionVSAvoidprocedure side effects

Core Design Contradiction:

ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The patent extracts the stimulation target from the dorsal root ganglion (DRG) location and relocates it to the renal afferent nerves. By stimulating renal afferent nerves directly, the procedure achieves the desired kidney function improvement without requiring placement of leads through the foramen, thereby eliminating the associated pain and foraminal stenosis complications while maintaining the therapeutic effect on kidney function.

Inventive Principle:

Principle #2Taking out (Extraction)

3Productivity

If multiple leads are used for effective DRG stimulation, then diuresis is promoted, but device complexity and fracture risk increase

Engineering Contradiction:

Improvediuresis promotionVSAvoidnumber of leads

Core Design Contradiction:

ProductivityVSDevice complexity

Solution Approach 1:

The patent employs a single multi-functional electrode that can stimulate renal afferent nerves effectively. This single electrode design consolidates the functionality that previously required multiple separate leads, thereby reducing device complexity and the risk of lead fracture while maintaining effective diuresis promotion through the reno-renal reflex pathway.

Inventive Principle:

Principle #6Universality (Multi-functionality)

Data Source

PatentUS20240261573A1Lateral epidural stimulation to affect kidney function

Publication Date: 2024.08.08 MEDTRONIC INC

AI summary

Systems, devices, and methods for affecting a patient's kidney function by activating the reno-renal reflex via electrical stimulation of preganglionic dorsal root fibers using one or more electrodes placed proximate preganglionic dorsal root fibers of one or more dorsal roots at the T10 to L1 vertebrae of the patient's spinal cord.